Cystic fibrosis carriership and tuberculosis: hints toward an evolutionary selective advantage based on data from the Brazilian territory

Background: The reason why Cystic Fibrosis (CF) is the most common fatal genetic disease among Caucasians has been incompletely studied. We aimed at deepening the hypothesis that CF carriers have a relative protection against Mycobacterium tuberculosis(Mtb) infection. Methods: Applying spatial epidemiology, we studied the link between CF carriership rate and tuberculosis ( TB) incidence in Brazil. We corrected for 5 potential environmental and 2 immunological confounders in this relation: monthly income, sanitary provisions, literacy rates, racial composition and population density along with AIDS incidence rates and diabetes mellitus type 2. Smoking data were incomplete and not available for analysis. Results: A significant, negative correlation between CF carriership rate and TB incidence, independent of any of the seven confounders was found. Conclusion: We provide exploratory support for the hypothesis that carrying a single CFTR mutation arms against Mtb infections.